As warmer weather approaches, we become more physically active, especially outdoors. It's also a time that emergency departments and urgent care centers are treating more head injuries.
Head injuries occur in all ages. The vast majority (80%) of traumatic brain injuries (TBIs) are mild. Forces which cause head injuries may be (direct) from a sudden direct blow to the head, or (indirect) from forces such as sudden acceleration/deceleration which results in movement of the brain inside the skull. Either type of injury can result in a concussion.
A concussion is a mild brain injury that commonly causes confusion, memory loss and headache. Some people do experience brief loss of consciousness. Concussions can happen after a person is hit on the head, face or neck, or their head and upper body is shaken too hard. They commonly occur from sports injuries, vehicle accidents and falls.
Immediate signs of concussion (minutes to hours) may include:
• Memory loss/confusion
• Headache
• Dizziness or trouble with balance
• Nausea or vomiting
• Feeling sleepy
• Acting strangely, cranky or out of sorts
Prolonged or chronic signs of concussions (hours to days or weeks) may include:
• Trouble walking or talking
• Memory problems or trouble concentrating
• Trouble sleeping
• Mood or behavior changes
• Sensitive to noise or light
Evaluation and testing should be performed by a qualified medical provider who is experienced in dealing with head injuries. Some head injuries require special testing, such as imaging studies like a CT or MRI scan, which can only be obtained in the emergency department. Determining where to go to be evaluated depends on the severity of the injury.
In general, the more incapacitating the symptoms are, especially if it involves loss of consciousness, seizure, severe headache, persistent vomiting, being on blood thinning medications and the very young or elderly, these persons should be seen in the emergency department. Urgent care is often able to treat minor concussions, but for more serious cases patients will be transferred to the emergency department via an appropriate and safe route.
Dr. Brian Cote’, FACEP